Ohio Prior Authorization Requirements for UnitedHealthcare Exchange Plans (Behavioral Health Services)
List of behavioral health services and revenue/procedure codes that require prior authorization for participating behavioral health providers for UnitedHealthcare Exchange Plans members in Ohio, effective January 1, 2025. Applies to inpatient and outpatient behavioral health services; excludes emergency/urgent care and is subject to member-specific benefit plan terms.
No material clinical/coverage changes
Policy Summary
This policy lists behavioral health inpatient and outpatient services that require prior authorization for participating behavioral health providers for UnitedHealthcare Exchange Plan members in Ohio, effective 2025-01-01. Providers must submit prior authorization requests using the Prior Authorization and Notification tool on UHCProvider.com (Sign In). Emergency and urgent care are exempt from prior authorization, and coverage determinations are subject to the member-specific benefit plan terms.